ArticleInternational journal of radiation oncology, biology, physics2023
Predicting Severity of Radiation Induced Lymphopenia in Individual Proton Therapy Patients for Varying Dose Rate and Fractionation Using Dynamic 4-Dimensional Blood Flow Simulations.
Article in International journal of radiation oncology, biology, physics, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
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Who cites it
20 citing papers in PubMed, 24 citations in OpenAlex.
- Dosimetric and Clinical Impact of Bone Marrow-sparing Radiation Therapy for Anal Cancer: A Systematic Review.Advances in radiation oncology · 2026Review
- Immunological biomarkers for precision stereotactic body radiation therapy in early-stage non-small cell lung cancer: a systematic review.EClinicalMedicine · 2026Article
- The microbiota-lymphocyte protective axis (MLPA): a novel paradigm for overcoming radiation-induced lymphopenia (RIL) and potentiating the efficacy of tumor immuno-combination therapy.Cancer immunology, immunotherapy : CII · 2026Review
- Preliminary treatment planning strategy for blood dose reduction in head and neck radiotherapy.Journal of applied clinical medical physics · 2026Article
- Local FLASH radiation exhibits a double-edged effect on the mouse immune system.Radiation oncology (London, England) · 2026Article
- Predictors of acute lymphopenia after radiotherapy for prostate cancer including pelvic node irradiation: results of a real-world prospective multi-centric study.ESMO real world data and digital oncology · 2026Article
- Blood dose estimates in radiotherapy and correlations with adverse clinical outcomes in hepatocellular carcinoma.Journal of radiation research · 2026Article
- Radiation-Induced Lymphopenia: In Silico Replications of Preclinical Studies Suggest Importance of Dose to Lymphoid Organs.International journal of radiation oncology, biology, physics · 2025Article
- Dosimetrically coupled multiscale tetrahedral mesh models of human liver vasculature: implications for radiopharmaceutical dosimetry of both organ blood and parenchyma.Physics in medicine and biology · 2025Article
- Patient-specific modeling of radiation-induced lymphopenia for head and neck cancer.Medical physics · 2025Article
- Evaluating the Impact of Liver Vasculature Model Complexity for Estimating Dose to Circulating Blood During Radiation Therapy.International journal of radiation oncology, biology, physics · 2025Article
- Proceedings of the National Cancer Institute Workshop on combining immunotherapy with radiotherapy: challenges and opportunities for clinical translation.The Lancet. Oncology · 2025Article
- Radiotherapy elicits immunogenic cell death and metabolic shifts in the tumor microenvironment: implications for immunotherapy.International journal of medical sciences · 2025Review
- Radiation-Induced Lymphopenia Prognosis and Risk Factors in Postmastectomy Radiotherapy Patients.Cancer management and research · 2025Article
- Radiation-Induced Lymphopenia is a Causal Mediator of Survival After Chemoradiation Therapy for Esophagus Cancer.Advances in radiation oncology · 2024Article
- Dose Rate Effects from the 1950s through to the Era of FLASH.Radiation research · 2024Review
- Nomogram for radiation-induced lymphopenia in patients receiving intensity-modulated radiotherapy based-chemoradiation therapy for newly diagnosed glioblastoma: A multi-institutional study.Clinical and translational radiation oncology · 2024Article
- Clinical application of high-LET radiotherapy combined with immunotherapy in malignant tumors.Precision radiation oncology · 2024Review
- A stochastic model of blood flow to calculate blood dose during radiotherapy.Physics in medicine and biology · 2023Article
- A review on lymphocyte radiosensitivity and its impact on radiotherapy.Frontiers in oncology · 2023Review
Corrections and comments
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Authors and funding
15 authors at 4 institutions in 1 country.
Funding
Abstract
purposeRadiation-induced lymphopenia has gained attention recently as the result of its correlation with survival in a range of indications, particularly when combining radiation therapy (RT) with immunotherapy. The purpose of this study is to use a dynamic blood circulation model combined with observed lymphocyte depletion in patients to derive the in vivo radiosensitivity of circulating lymphocytes and study the effect of RT delivery parameters. METHODS AND MATERIALS: We assembled a cohort of 17 patients with hepatocellular carcinoma treated with proton RT alone in 15 fractions (fx) using conventional dose rates (beam-on time [BOT], 120 seconds) for whom weekly absolute lymphocyte counts (ALCs) during RT and follow-up were available. We used HEDOS, a time-dependent, whole-body, blood flow computational framework, in combination with explicit liver blood flow modeling, to calculate the dose volume histograms for circulating lymphocytes for changing BOTs (1 second-300 seconds) and fractionations (5 fx, 15 fx). From this, we used the linear cell survival model and an exponential model to determine patient-specific lymphocyte radiation sensitivity, α, and recovery, σ, respectively.
resultsThe in vivo-derived patient-specific α had a median of 0.65 Gy
conclusionsWe observed that increasing dose rate at the same fractionation reduced ALC depletion more significantly than reducing the number of fractions. High-dose-rates led to an increased sparing of lymphocytes when shortening the fractionation regimen, particularly for patients with radiosensitive lymphocytes at elevated risk.
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Registered trials
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